The present invention generally relates to rapid reporting of meaningful use of electronic health records and related technology within a healthcare organization.
Meaningful use (MU), in a health information technology (HIT) context, refers to the use of electronic health records (EHR) and related technology within a healthcare organization in a way that meets certain criteria. It has been said that meaningful use means “providers need to show they're using certified EHR technology in ways that can be measured significantly in quality and in quantity.” In the U.S., achieving meaningful use can be a requirement for receiving federal funding under some incentive programs.
Implementation of the Meaningful Use system in the U.S. has been divided into three stages, with the first (stage 1) being used as an eligibility criteria beginning in the 2011-2012 timeframe and the others being used in years thereafter. Stage 1 sets the basic functionalities for EHRs. More particularly, Stage 1 meaningful use criteria set the baseline for electronic data capture and information sharing. The requirements are focused on providers capturing patient data and sharing that data either with the patient or with other healthcare professionals. In at least some programs, eligible professionals, eligible hospitals, and critical access hospitals will successfully attest to two stage 1 reporting periods before moving to stage 2.
The first steps in achieving meaningful use are to have a certified electronic health record (EHR) and to be able to demonstrate that it is being used to meet the requirements. Stage 1 contains 25 objectives/measures for Eligible Providers (EPs) and 24 objectives/measures for eligible hospitals (EHs). The objectives/measures have been divided into a core set and a menu set. EPs and EHs must meet all objectives/measures in the core set (15 for EPs and 14 for EHs). EPs must meet 5 of the 10 menu-set items during Stage 1, one of which must be a public health objective. The core requirements for Stage 1 include: (1) use computerized order entry for medication orders; (2) implement drug-drug, drug-allergy checks; (3) generate and transmit permissible prescriptions electronically; (4) record demographics; (5) maintain an up-to-date problem list of current and active diagnoses; (6) maintain active medication list; (7) maintain active medication allergy list; (8) record and chart changes in vital signs; (9) record smoking status for patients 13 years old or older; (10) implement one clinical decision support rule; (11) report ambulatory quality measures to Center for Medicare & Medicaid Services (CMS) or the States; (12) provider patients with an electronic copy of their health information upon request; (13) provide clinical summaries to patients for each office visit; (14) capability to exchange key clinical information electronically among providers and patient-authorized entities; and (15) protect electronic health information (privacy and security). A list of the menu requirements is not set forth herein but is readily available from a wide variety of sources.
Compliance with the requirements entails the creation of many reports based on all of an EP's or EH's patient encounters. Prior art meaningful use (stage 1) systems complete all the computational processing for a particular report at the time the report is created. Unfortunately, when used on a large scale, prior art approaches perform numerous and repeated aggregations and conditions against millions or billions of records to calculate Meaningful Use (stage 1) reports. Furthermore, as client demand for reports increases, the probability of dead-locking increases exponentially, forcing report requests to be placed in a queue for processing. This queuing effect can delay report production for hours (often to the next day) and has become a substantial source of dissatisfaction for users. Users are often so dissatisfied that they use various tools to automatically trigger report generation at a predetermined interval, regardless of whether a report is actually needed. This in turn compounds the problem by escalating the demand on servers which leads to slower performance.
A secondary issue relates to the demand placed on the hardware in terms of processing and disk demands. Driven by an enormous amount of data I/O, the uninterrupted load tends to decrease the life of system hardware. Not only does this directly increase infrastructure cost, but it increases the potential for downtime as well as the loss of data.
It is believed that an improved framework could be architected and implemented that would deliver accurate and timely results in seconds rather than hours, thereby improving the value and insights of Meaningful Use. One or more aspects and features of the invention are believed to provide such enhancement.